Canzio Romano

Bladder Cancer Mortality of Workers Exposed to Aromatic Amines: A 58-Year Follow-up

We previously investigated bladder cancer risk in a cohort of dyestuff workers who were heavily exposed to aromatic amines from 1922 through 1972. We updated the follow-up by 14 years (through 2003) for 590 exposed workers to include more than 30 years of follow-up since last exposure to aromatic amines. Expected numbers of deaths from bladder cancer and other causes were computed by use of national mortality rates from 1951 to 1980 and regional mortality rates subsequently. There were 394 deaths, compared with 262.7 expected (standardized mortality ratio = 1.50, 95% confidence interval = 1.36 to 1.66). Overall, 56 deaths from bladder cancer were observed, compared with 3.4 expected (standardized mortality ratio = 16.5, 95% confidence interval = 12.4 to 21.4). The standardized mortality ratio for bladder cancer increased with younger age at first exposure and increasing duration of exposure. Although the standardized mortality ratio for bladder cancer steadily decreased with time since exposure stopped, the absolute risk remained approximately constant at 3.5 deaths per 1000 man-years up to 29 years after exposure stopped. Excess risk was apparent 30 years or more after last exposure.

Factors related to the development of sensitization to green coffee and castor bean allergens among coffee workers

Background Occupational allergic respiratory symptoms in coffee workers have been frequently reported, but the ultimate cause of sensilization is still debated, castor bean being considered besides green coffee beans. Atopy and cigarette smoking have been suggested as promoting factors of sensitizalion for several occupational allergens. Objective This study was carried out to assess the prevalence of allergic respiratory symptoms and of sensitization to both green coffee beans and castor bean in the whole workforce of a coffee manufacturing plant. Furthermore we wanted to ascertain both the presence of castor bean antigens in the settled dust of the green coffee beans warehouse and the possible crossreactivity between the two beans. Meanwhile, the effect of smoking and atopy was considered.

Features and severity of occupational asthma upon diagnosis: an Italian multicentric case review

Background. The severity of occupational asthma (OA) at the time of diagnosis is not known. In this study we aimed to evaluate some features of the disease at the time of diagnosis, particularly looking at severity and treatment before diagnosis.

Updated mortality study of a cohort of asbestos textile workers

Limited information is available on risk of peritoneal mesothelioma after asbestos exposure, and in general on the risk of cancer after cessation of asbestos exposure. We updated to 2013 the follow‐up of a cohort of 1083 female and 894 male textile workers with heavy asbestos exposure (up to 100 fb/mL), often for short periods. A total of 1019 deaths were observed, corresponding to a standardized mortality ratio (SMR) of 1.68 (95% confidence interval [CI]: 1.57–1.78). SMRs were 29.1 (95% CI: 21.5–38.6) for peritoneal cancer, 2.96 (95% CI: 2.50–3.49) for lung cancer, 33.7 (95% CI: 25.7–43.4) for pleural cancer, and 3.03 (95% CI: 1.69–4.99) for ovarian cancer. For pleural and peritoneal cancer, there was no consistent pattern of risk in relation to time since last exposure, whereas for lung cancer there was an indication of a decline in risk after 25 years since last exposure. The findings of this unique cohort provide novel data for peritoneal cancer, indicating that – as for pleural cancer – the excess risk does not decline up to several decades after cessation of exposure.

Short-term respiratory changes in polyurethane foam workers exposed to low MDI concentration

SummaryOur study included 27 polyurethane foam workers exposed to MDI only at low concentrations (ranging from 0.0005 to 0.001 ppm) and 27 clerks from the same factory matched by age. Respiratory function tests were performed on a Monday and Friday of the same week at shift onset, 4 h later and at shift end. The subjects under study were asymptomatic for asthma. The two groups had quite similar spirometric values with minimal functional impairment. A statistical analysis was carried out by Students t-test for matched pairs and two-way analysis of variance (ANOVA), in order to take into account both occupational exposure and smoking habits. No significant differences between the two groups were observed with paired t-tests in the respiratory parameter trend during both the Monday and Friday work shift. Nor were differences observed within the two groups when Fridays and Mondays results were compared. No significant differences between the two groups were found in paired comparisons between Friday and Monday for respiratory parameters. ANOVA demonstrated that the FEV1 and FEF25-75 reduction present on Friday, when compared to Monday, was related to smoking and not to occupational exposure. In conclusion our findings showed no short-term respiratory changes in subjects exposed to low MDI concentration.

The prediction of recommended energy expenditure for an 8 h work-day using an air-purifying respirator.

Thirty railway workers executed maximal, or near maximal, stress tests with and without the use of a half mask air-purifying respirator (Spasciani 85 A1 P1) fitted with two combined filters for simultaneous protection from organic vapours and particulate matter. The pressure-flow characteristics of inspiratory and expiratory resistance at airflows in the range 0-90 l.min-1 were established by a continuous flow method on one test mask. Significant differences were found by paired t-test between the two exercises (with and without use of mask), showing reduced values with use of the mask, for breath frequency, ventilation rate, oxygen uptake, carbon dioxide production, maximal oxygen uptake, percentage of maximal voluntary ventilation used at the maximal exercise ventilation. No significant differences were found for tidal volume, respiratory quotient, heart rate, systolic blood pressure, oxygen uptake at anaerobic threshold, and duration of exercise. The predicted energy expenditure recommended for an 8 h work shift, corresponding to 40% of maximal oxygen uptake, is found to be reduced working with respirator and is significantly different from that observed during stress test without mask. The average ventilation rate at this workload is below 25 l.min-1, with predicted inspiratory mouth pressure equal to, or less than, 20 mm H2O. This maximal inspiratory mouth pressure is proposed as a safety limit for prolonged work using a respirator, with a recommended energy expenditure close to 40% of maximal oxygen uptake.

Mortality from cancer and other causes among Italian chrysotile asbestos miners

Objective To investigate the long-term mortality of a cohort of Italian asbestos miners. Methods The cohort included 1056 men employed in a chrysotile mine between 1930 and 1990, who were followed up during 1946–2014, for a total of 37 471 person-years of observation. Expected deaths and SMRs were computed using national and local (after 1980, when available) reference. Results A total of 294 (27.8%) subjects were alive and at the end of follow-up, 722 (68.4%) were dead and 40 (3.8%) were lost to follow-up. The SMR for overall mortality was 1.35 (95%CI 1.25 to 1.45). The SMR for pleural cancer, based on seven observed deaths, was 5.54 (95% CI 2.22 to 11.4) and related to time since first exposure, but not to duration of employment, cumulative exposure or time since last exposure. The SMR for lung cancer was 1.16 (95% CI 0.87 to 1.52; 53 observed deaths), with no excess among workers with cumulative exposure below 100 fibre/mL-years (SMR 0.82; 95% CI 0.44 to 1.40). Conclusions The update of the follow-up of this cohort confirmed an increased mortality from pleural cancer mortality in miners exposed to chrysotile and a lack of significant increase in lung cancer mortality.

Assessment of DNA Damage and Telomerase Activity in Exfoliated Urinary Cells as Sensitive and Noninvasive Biomarkers for Early Diagnosis of Bladder Cancer in Ex-Workers of a Rubber Tyres Industry

The aim of the present study was to identify sensitive and noninvasive biomarkers of early carcinogenic effect at target organ to use in biomonitoring studies of workers at risk for previous occupational exposure to potential carcinogens. Standard urine cytology (Papanicolaou staining test), comet assay, and quantitative telomerase repeat amplification protocol (TRAP) assay were performed in 159 ex-rubber workers employed in tyres production and 97 unexposed subjects. In TRAP positive cases, a second level analysis using FISH (Urovysion) was done. Cystoscopy results were available for 11 individuals whose 6 FISH/TRAP/comet positive showed in 3 cases a dysplastic condition confirmed by biopsy, 1 comet positive resulted in infiltrating UBC to the biopsy and with hyperplasia and slight dysplasia to the urinary cytology, 1 comet positive resulted in papillary superficial UBC to the biopsy, 1 FISH/TRAP positive showed a normal condition, and 2 TRAP positive showed in one case a phlogosis condition. The results evidenced good concordance of TRAP, comet, and FISH assays as early biomarkers of procarcinogenic effect confirmed by the dysplastic condition and UBC found by cystoscopy-biopsy analysis. The analysis of these markers in urine cells could be potentially more accurate than conventional cytology in monitoring workers exposed to mixture of bladder potential carcinogens.

Cancer mortality in a cohort of continuous glass filament workers

Objective. To examine cancer mortality in continuous glass filament workers. Methods. A cohort of 936 continuous glass filament workers employed in a plant from northern Italy since January 1976 was followed-up through December 2003, for a total of 19,987 man-years. Results. Overall, 144 deaths were observed compared with 160.8 expected based on regional death rates (standardized mortality ratio [SMR] = 0.90, 95% CI = 0.76 to 1.05). There were 53 deaths from all cancers (SMR = 1.01, 95% CI = 0.75 to 1.32), and 21 from lung cancer (SMR = 1.23, 95% CI = 0.76 to 1.89). There was no consistent relation with risk for age at first employment, time since first or last employment, or duration of employment for any of the causes considered. Conclusions. Although limited in size, this study provides no evidence that continuous glass filament workers experience a significant increased risk of cancer, including respiratory cancer.

Validation of the diagnosis of mesothelioma and BAP1 protein expression in a cohort of asbestos textile workers from Northern Italy

Background Diagnosis of mesothelioma based on death certificate is subject to misclassification, which may bias the results of epidemiology studies. A high proportion of mesothelioma harbor mutations in the BRCA1-associated protein 1 (BAP1) gene. Methods We searched medical and pathology records and specimens for 127 workers from a textile-asbestos factory in Italy who died during 1963-2013 with a diagnosis of pleural or peritoneal neoplasm or mesothelioma on death certificate, to confirm the diagnosis with immunohistochemistry markers. We calculated the odds ratio of confirmation by selected characteristics and asbestos exposure variables. When sufficient pathology material was available, we analyzed BAP1 protein expression. Results The diagnosis of mesothelioma was histologically confirmed for 35 cases (27.6%); 5 cases were classified as non-mesothelioma (3.9%), for 33 cases a mention of mesothelioma was found on record but no sufficient material was available for revision (26.0%); no records were available for 54 cases (death-certificate-only 42.5%). Diagnostic confirmation was not associated with sex, location of the neoplasm, age, or duration of employment; however, there was a significant association with time since first employment (P for linear trend 0.04). An association between duration of employment and time since first employment was observed for confirmed cases but not for death-certificate-only cases. BAP1 protein was lost in 18/35 cases (51.4%), without an association with sex, location, age, indices of asbestos exposure, or survival. Conclusions We were able to confirm by immunohistochemistry a small proportion of mesothelioma diagnoses on certificates of deceased asbestos workers, and confirmation correlated with latency of asbestos exposure but not other characteristics. BAP1 protein loss is a frequent event in mesothelioma of asbestos-exposed workers, but does not correlate with exposure.